Plantar Fasciitis is a painful foot condition that causes pain at the bottom of the heel.
Are you worried you have this condition?
Or, perhaps you’re confused about why you have ankle pain when your doctor says Plantar Fasciitis affects the foot. Are the two things connected?
This blog contains everything you need to know about this painful condition. Including how to treat it and walk, run, and jump again without pain and the tell-tale sensation of walking across hot coals. The critical thing to remember, however, is that it doesn’t have to be permanent. I can and does get better with the proper treatment.
But first, here’s a quick anatomy lesson on the plantar fascia – the ligament that causes plantar fasciitis pain; What is it, and what does it do?
Well, the heel is connected to the front of the foot by a thick web type ligament known as the plantar fascia. It’s a thick band of connective tissue that, apart from providing support to the foot arch and assisting in walking, also serves as a shock absorber. The shock-absorbing component is why it’s such a common complaint in runners.
It is among the most common orthopedic issues because the ligaments at the bottom of the foot experience much wear and tear through life. This wear and tear and potential for degeneration are even more pronounced in overweight patients or people who spend lots of time on their feet. In addition, wearing improper footwear that doesn’t provide the correct type of support compounds the issue.
In these cases, the extra pressure on the plantar fascia causes the ligaments to inflate, damage, or develop tears that lead to stiffness and pain.
Although the exact cause of plantar fasciitis is still unknown, we think it is degeneration rather than inflammation that leads to plantar fasciitis.
What Are The Symptoms Of Plantar Fasciitis?
- A common symptom among plantar fasciitis patients is a sharp pain in the bottom mid-foot region or heel.
- While it generally occurs in one foot, it can happen in both as well.
- The pain develops gradually and can be either sharp or dull.
- Some patients experience an ache or burning sensation at the bottom of the foot that extends along from the heel.
- The pain is more severe in the morning after getting out of bed or when you get up after sitting or lying down for some time.
- It makes climbing stairs a challenge because of stiffness in the heel.
- Remaining active for a lengthy period can increase inflammation as well. But generally, the pain is not felt when active but rather after stopping.
Plantar Fasciitis And Ankle Pain: What’s The Connection?
Heel and foot pain is the most common symptom of plantar fasciitis. Still, suppose the plantar fascia ligament is inflamed and presses on the surrounding nerves. In that case, you may also feel pain radiating up towards your ankle.
Does that sound like you?
It might be plantar fasciitis, but sometimes ankle pain relates to a completely different condition – like a sprained ankle or tendonitis. So it’s essential to have your foot and ankle checked over by a Physiotherapist.
Who Gets Plantar Fasciitis? And What Causes It?
Plantar Fasciitis is more common among men and women in the age groups of 40-70 – especially those that lead a very active lifestyle. However, we tend to find Plantar fasciitis to be more common in women than men.
Pregnant women may frequently suffer from plantar fasciitis, especially during the later stages of pregnancy.
Those suffering from obesity or being excessively overweight are more likely to suffer from it too. This predisposition is mainly because of the increased pressure on the ligaments, especially if the weight gain is sudden.
Long-distance runners are also particularly susceptible to plantar fasciitis. Likewise, those that have to remain on their feet as part of their job for long durations are also more likely to exhibit symptoms of plantar fasciitis.
Those that have structural issues with their feet, like flat feet or predominant arches, are also likely to suffer from plantar fasciitis at some stage. Similarly, those that have taut Achilles tendons that are the muscles that attach the calf to the heel, are also prone to plantar fasciitis.
Lastly, shoes that offer poor support to the foot’s arch or have soft soles can also cause the issue.
Is It Plantar Fasciitis?
To determine if the cause of your symptoms is plantar fasciitis, your doctor or Physiotherapist will conduct an examination of your foot and check for pain and tenderness at the precise location of the plantar fascia. This exam confirms if the underlying issue is related to this ligament. During the examination, we ask you to flex the foot.
At the same time, we apply pressure to determine if the pain worsens while flexing and reduces while pointing the toes. We also check for swelling and redness, evaluate the corresponding nerves and the strength of the muscles. We do this by:
- Examining your coordination and balance
- Checking the reflexes in your heel and muscles
- Checking the muscle tone in the area
- Analyzing your sensory perception when we touch the foot
We may also recommend an MRI scan or X-rays to determine if there is any other cause for pain in the heel, e.g., a bone fracture. We can’t see Plantar Fasciitis on an X-ray. Still, scans allow us to give a differential diagnosis, especially if you present with non-typical symptoms.
How To Treat Plantar Fasciitis
The standard treatment for plantar fasciitis is to reduce inflammation, like using ice and Advil to reduce the swelling and getting ample rest to help your body heal. But in cases where these treatments do not reduce your pain, your doctor might recommend a corticosteroid injection directly into the affected ligament. They may use an ultrasound to evaluate the ideal spot to administer the drug to provide this injection. Or they may apply corticosteroids on the heel’s skin followed by a non-painful electric current stimulus to assist the medication in travelling through the skin to the affected muscle.
If conservative treatment methods are not successful, the doctor might consider recommending extracorporeal shock wave therapy. It involves the use of sound waves directed at the heel to heal the ligament. Some of the side-effects might be:
When extracorporeal shock wave therapy and other treatments don’t help improve the symptoms, the next alternative is to go in for surgery. The surgical procedure that treats plantar fasciitis is called a “fasciotomy” – where the surgeon “releases” the plantar fascia with an incision that disconnects it from your heel bone. In doing so, the ligament is encouraged to lengthen when the cut heals, which reduces the tension and pressure and gets rid of the pain.
The surgery has a reasonable 70-90% success rate. Still, it should always be viewed as a last resort, as is the case with all surgeries because, although rare, they all come with a risk of infection or accidental injury. Plus, you could be in the 10-30% of patients for whom the surgery doesn’t work, so the downtime and recovery period after the surgery would have been for nothing.
So, if you want to avoid pain pills, steroid injections, and dangerous surgeries, physiotherapy is 100% more effective in treating Plantar Fasciitis. We regularly treat patients with this painful condition by helping them to stretch the Achilles tendons and plantar fascia. We also guide you through a series of exercises to help strengthen the muscles in your lower leg and ankle and help you walk in a more balanced manner reducing pressure on your heel.
Do you want to find out more? Book a free consultation now.
How To Reduce Plantar Fasciitis Pain
If you’re in pain right now, stretching exercises can help reduce plantar fasciitis pain. For example, stretching exercises for the calve muscles. Pulling your toes towards your body or using a foam roller to stretch the plantar fascia all help loosen the ligaments and alleviate pain.
You also need to take extra care to avoid high-impact activities like running that can aggravate the fascia and worsen the pain. We recommend at least two weeks off running to see if the pain improves to treat mild plantar fasciitis pain. Instead, low-impact exercises like swimming can help you stay active without impacting the healing process. But check with your doctor or Physiotherapist before commencing any new exercise routine. But if the pain returns after a fortnight’s break, we recommend you seek help from a Physiotherapist before running again.
Once you begin regular exercises, it is vital to warm up and practice stretching exercises before starting any workout. Your Physiotherapist will demonstrate the right stretching exercises to prevent and heal Plantar Fasciitis.
You can get in touch with me through our contact page, or book a free Discovery visit here. We’ll get you back on your feet (no pun intended!) and back to health. And please remember, this condition is nothing to feel ashamed or embarrassed about. It’s a common issue that I treat all the time. As such, you’re in good hands!